Marco Barbanti1, John G Webb2, Claudia Tamburino2, Nicolas M Van Mieghem2, Raj R Makkar2, Nicolò Piazza2, Azeem Latib2, Jan-Malte Sinning2, Kim Won-Keun2, Sabine Bleiziffer2, Francesco Bedogni2, Samir Kapadia2, Didier Tchetche2, Josep Rodés-Cabau2, Claudia Fiorina2, Luis Nombela-Franco2, Federico De Marco2, Peter P de Jaegere2, Tarun Chakravarty2, Beatriz Vaquerizo2, Antonio Colombo2, Lars Svensson2, Rüdiger Lange2, Georg Nickenig2, Helge Möllmann2, Thomas Walther2, Francesco Della Rosa2, Yacine Elhmidi2, Danny Dvir2, Nedy Brambilla2, Sebastiano Immè2, Carmelo Sgroi2, Simona Gulino2, Denise Todaro2, Gerlando Pilato2, Anna Sonia Petronio2, Corrado Tamburino2. 1. From the Ferrarotto Hospital, University of Catania, Italy (M.B., Claudia Tamburino, S.I., C.S., S.G., D.T., G.P., Corrado Tamburino); St Paul's Hospital, Vancouver, Canada (J.G.W., D.D.); Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands (N.M.V.M., P.P.d.J.); Cedars-Sinai Heart Institute, Los Angeles, CA (R.R.M., T.C.); McGill University Health Center, Montreal, Québec, Canada (N.P.); EMO-GVM Centro Cuore Columbus and San Raffaele Scientific Institute, Milan, Italy (A.L., A.C.); Heart Centre Bonn, Department of Medicine II, University Hospital Bonn, Germany (J.-M.S., G.N.); Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (K.W.-K., H.M., T.W.); German Heart Center Munich, Technical University Munich, Germany (S.B., B.V., R.L., Y.E.); IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (F.B., F.D.M., N.B.); Cleveland Clinic Foundation, OH (S.K., L.S.); Clinique Pasteur, Toulouse, France (D.T., F.D.R.); Quebec Heart & Lung Institute, Laval University, Quebec City, Canada (J.R.-C.); Spedali Civili, Brescia, Italy (C.F.); Hospital Clínico Universitario San Carlos, Madrid, Spain (L.N.-F.); and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (A.S.P.). mbarbanti83@gmail.com. 2. From the Ferrarotto Hospital, University of Catania, Italy (M.B., Claudia Tamburino, S.I., C.S., S.G., D.T., G.P., Corrado Tamburino); St Paul's Hospital, Vancouver, Canada (J.G.W., D.D.); Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands (N.M.V.M., P.P.d.J.); Cedars-Sinai Heart Institute, Los Angeles, CA (R.R.M., T.C.); McGill University Health Center, Montreal, Québec, Canada (N.P.); EMO-GVM Centro Cuore Columbus and San Raffaele Scientific Institute, Milan, Italy (A.L., A.C.); Heart Centre Bonn, Department of Medicine II, University Hospital Bonn, Germany (J.-M.S., G.N.); Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (K.W.-K., H.M., T.W.); German Heart Center Munich, Technical University Munich, Germany (S.B., B.V., R.L., Y.E.); IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (F.B., F.D.M., N.B.); Cleveland Clinic Foundation, OH (S.K., L.S.); Clinique Pasteur, Toulouse, France (D.T., F.D.R.); Quebec Heart & Lung Institute, Laval University, Quebec City, Canada (J.R.-C.); Spedali Civili, Brescia, Italy (C.F.); Hospital Clínico Universitario San Carlos, Madrid, Spain (L.N.-F.); and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy (A.S.P.).
Abstract
BACKGROUND: Transcatheter aortic valves can degenerate in a manner similar to surgical bioprostheses. METHODS AND RESULTS: Clinical and echocardiographic outcomes of patients who underwent redo transcatheter aortic valve replacement (TAVR) procedures >2 weeks post procedure were collected from 14 centers. Among 13 876 patients, 50 (0.4%) underwent redo TAVR procedure at participating centers. Indications for redo TAVR were moderate-severe prosthetic aortic valve stenosis (n=10, 21.7%), moderate-severe central prosthetic aortic valve regurgitation (n=13, 28.3%), and moderate-severe paraprosthetic aortic valve regurgitation (n=25, 50.0%). The index TAVR was most commonly a Medtronic CoreValve (N=38, 76.0%), followed by Edwards SAPIEN-type valves (n=12, 24.0%) and Portico (n=1, 2.0%). The redo TAVR device was most commonly a CoreValve/Evolut R (n=29, 58.0%), followed by a SAPIEN-type valve (n=20,40.0%) or a Boston Lotus valve (n=1, 2.0%). In 40 patients (80.0%), redo TAVR was performed using the identical device type or that of the succeeding generation. Valve performance was uniformly good after redo TAVR (mean transvalvular gradient post redo TAVR: 12.5±6.1 mm Hg). At hospital discharge, all patients remained alive, with 1 nondisabling stroke (2.0%) and 1 life-threatening bleed (2.0%). Permanent pacemaker implantation was required in 3 out of 35 patients without a prior pacemaker (8.6%). Late survival was 85.1% at a median follow-up of 1589 days (range: 31-3775) after index TAVR and 635 days (range: 8-2460) after redo TAVR. CONCLUSIONS: Redo TAVR for the treatment of postprocedural and late occurrence of paravalvular regurgitation and transcatheter aortic valve prosthesis failure seems to be safe, and it is associated with favorable acute and midterm clinical and echocardiographic outcomes.
BACKGROUND: Transcatheter aortic valves can degenerate in a manner similar to surgical bioprostheses. METHODS AND RESULTS: Clinical and echocardiographic outcomes of patients who underwent redo transcatheter aortic valve replacement (TAVR) procedures >2 weeks post procedure were collected from 14 centers. Among 13 876 patients, 50 (0.4%) underwent redo TAVR procedure at participating centers. Indications for redo TAVR were moderate-severe prosthetic aortic valve stenosis (n=10, 21.7%), moderate-severe central prosthetic aortic valve regurgitation (n=13, 28.3%), and moderate-severe paraprosthetic aortic valve regurgitation (n=25, 50.0%). The index TAVR was most commonly a Medtronic CoreValve (N=38, 76.0%), followed by Edwards SAPIEN-type valves (n=12, 24.0%) and Portico (n=1, 2.0%). The redo TAVR device was most commonly a CoreValve/Evolut R (n=29, 58.0%), followed by a SAPIEN-type valve (n=20,40.0%) or a Boston Lotus valve (n=1, 2.0%). In 40 patients (80.0%), redo TAVR was performed using the identical device type or that of the succeeding generation. Valve performance was uniformly good after redo TAVR (mean transvalvular gradient post redo TAVR: 12.5±6.1 mm Hg). At hospital discharge, all patients remained alive, with 1 nondisabling stroke (2.0%) and 1 life-threatening bleed (2.0%). Permanent pacemaker implantation was required in 3 out of 35 patients without a prior pacemaker (8.6%). Late survival was 85.1% at a median follow-up of 1589 days (range: 31-3775) after index TAVR and 635 days (range: 8-2460) after redo TAVR. CONCLUSIONS: Redo TAVR for the treatment of postprocedural and late occurrence of paravalvular regurgitation and transcatheter aortic valve prosthesis failure seems to be safe, and it is associated with favorable acute and midterm clinical and echocardiographic outcomes.
Authors: Alexander A Brescia; G Michael Deeb; Stephane Leung Wai Sang; Daizo Tanaka; P Michael Grossman; Devraj Sukul; Chang He; Patricia F Theurer; Melissa Clark; Francis L Shannon; Stanley J Chetcuti; Shinichi Fukuhara Journal: Circ Cardiovasc Interv Date: 2021-03-15 Impact factor: 6.546
Authors: Shinichi Fukuhara; Alexander A Brescia; Suzuna Shiomi; Carlo M Rosati; Bo Yang; Karen M Kim; G Michael Deeb Journal: J Thorac Cardiovasc Surg Date: 2020-01-12 Impact factor: 6.439
Authors: Francesco Onorati; Riccardo Gherli; Giovanni Mariscalco; Evaldas Girdauskas; Eduardo Quintana; Francesco Santini; Marisa De Feo; Sandro Sponga; Piergiorgio Tozzi; Mohamad Bashir; Andrea Perrotti; Aniello Pappalardo; Vito Giovanni Ruggieri; Giuseppe Santarpino; Mauro Rinaldi; Silva Ronaldo; Francesco Nicolini Journal: BMJ Open Date: 2018-02-10 Impact factor: 2.692